02027nas a2200385   4500000000100000008004100001260001300042653002600055653004200081653002100123653001600144653000800160653001900168653001100187653004800198653001400246653001200260653002500272653003100297653002400328653001700352100001400369700001400383700002400397700001700421700001100438700001400449700001200463245005400475300001100529490000600540050001600546520106500562022001401627       2011                            d  c2011 Jun10aAnti-Bacterial Agents10aAntiretroviral Therapy, Highly Active10aAntiviral Agents10aComorbidity10aHIV10aHIV Infections10aHumans10aImmune Reconstitution Inflammatory Syndrome10aIncidence10aleprosy10aMycobacterium leprae10aMycobacterium tuberculosis10aSpecies Specificity10aTuberculosis1 aMassone C1 aTalhari C1 aRibeiro-Rodrigues R1 aSindeaux RHM1 aMira M1 aTalhari S1 aNaafs B00aLeprosy and HIV coinfection: a critical approach.  a701-100 v9  aMASSONE20113 a<p>An increase in leprosy among HIV patients, similar to that observed in patients with TB, was expected approximately 20 years ago. Studies conducted in the 1990s together with those reported recently seemed to indicate that a coinfection with HIV did not alter the incidence and the clinical spectrum of leprosy and that each disease progressed as a single infection. By contrast, in countries with a high seroprevalence of HIV, TB was noted to increase. Explanations may be provided by the differences in the incubation time, the biology and toxicity of Mycobacterium leprae and Mycobacterium tuberculosis. After the introduction of HAART the leprosy-HIV coinfection manifested itself as an immune reconstitution inflammatory syndrome (IRIS), typically as paucibacillary leprosy with type 1 leprosy reaction. The incidence of leprosy in HIV-infected patients has never been properly investigated. IRIS-leprosy is probably underestimated and recent data showed that the incidence of leprosy in HIV patients under HAART was higher than previously thought.</p>  a1744-8336